TAC Press Release, 8 May 2001 Included: * Press Statment on Mother-to-Child Transmission of HIV Prevention Programme * Letter sent by TAC to Minister of Health (26 April, 2001) * Reply by Department of Health to the Above Letter (30 April, 2001) * Letter sent by TAC to the Medicines Control Council on Nevirapine Registration (17 April, 2001) (No reply received, though the next day Dr Helen Rees made a statement to the press) For further comment, phone: Promise Mthembu (031) 304 3673 Anneke Meerkotter 072 247 8990 TAC Press Statement on Mother-to-Child Transmission *************************************************** TAC CONDEMNS FURTHER DELAYS IN MTCTP IMPLEMENTATION Press Statement issued by the Treatment Action Campaign on 8 May 2001 at a press conference in Durban. The Treatment Action Campaign (TAC) has waited patiently for the South African government to fulfill the constitutional right of every pregnant woman to dignity, reproductive choices and access to health care services, through the provision of access to programmes to prevent the transmission of HIV from mother-to-child that include either nevaripine or AZT. Given the state of the HIV pandemic, MTCTP for HIV is an essential part of the services that should be available to all pregnant women, including voluntary counseling and testing services, termination of pregnancy services, and proper follow up, monitoring and treatment of mother and infant by a doctor at all times. TAC firmly believes that the government could, with political will, successfully implement its planned 18 MTCTP sites throughout the country and extend this to a national programme by the end of the year. This programme was scheduled to begin in March, and there is no justification in this or any other further delay. At a recent National Executive Committee meeting including representatives from all major trade union formations, People Living with AIDS, NGOs, faith-based organisations and the children's sector, a resolution was taken which mandated the TAC Executive to institute legal action should it be necessary. TAC looks forward to a rapid resolution of this issue of life and death. We further call on government, including the Department of Health and bodies such as the Medicines Control Council to communicate information clearly and regularly regarding matters of such obvious public interest, including plans for implementation, full reasons for any delays and alternative plans, as well as registration of live saving medications. [ENDS] Dr Manto Tshabalala-Msimang Minister of Health Private Bag X399 Pretoria 0001 26th April 2001 CC: Mr Thabo Mbeki, President of South Africa Mr Jacob Zuma, Deputy-President of South Africa Dr Essop Pahad, Minister in the Presidency Mr Trevor Manuel, Minister of Finance Mr Alec Erwin, Minister of Trade and Industry Dr Zola Skweyiya, Minister of Social Development Dear Minister Tshabalala-Msimang, The tremendous moral and legal victory signalled by the withdrawal of the court action by the PMA gave hope to millions of our people that government would be able to proceed unfettered in its programme to combat the HIV/AIDS epidemic with renewed vigour. TAC has demonstrated, through its participation in the case and through its other campaigns, that government can count on it in this just cause. Our principled position has also meant that TAC will be its sternest critic should there be any wavering from this cause. This letter addresses the wholly unsatisfactory manner in which government is handling the Prevention of Mother-to-Child Transmission (PMTCT) of HIV. Last year, the government made a commitment to implement PMTCT, using nevirapine, in 18 sites around the country. According to media statements made by members of the government, this would reach approximately 100,000 pregnant women, or 10% of expectant mothers attending antenatal clinics. As you are aware, TAC had earlier indicated its intention to take legal action to enforce the implementation of a country-wide Prevention of Mother-to-Child Transmission (PMTCT) programme. The announcement of the government's proposal to implement a nevirapine- based PMTCT pilot programme, while inadequate, was accepted as the first phase in the progressive realisation of a country-wide programme for PMTCT. TAC therefore suspended its intended legal action in the belief that the government was acting in good faith. We have now learnt that the implementation of Prevention of Mother-to-Child Transmission (PMTCT) at sites in the Free State, the Western Cape, Northern Province and Kwazulu-Natal, which was due to begin in April 2001, has been delayed. We were also deeply concerned by reports that the decision to use nevirapine has been referred back to cabinet. The effect of this step will be to further delay the implementation of the pilot programmes. The prevarication by government, in the face of spiralling HIV infection statistics, is unconscionable. TAC cannot, and will not, stand idly by while the situation deteriorates. We therefore require, by Wednesday 2 May 2001, your response to the following: · the reasons for the delay in implementing PMTCT in the four provinces mentioned above; · the reasons for referring the decision to use nevirapine back to cabinet; · when a decision on the use of nevirapine will be made by cabinet; · a clear commitment to implement the remainder of the pilot programme, including the use of nevaripine, and proper voluntary counselling and testing (VCT), on schedule; * a clear commitment to implement a country-wide PMTCT programme by December 2001 or, at the latest, June 2002. There is widespread consensus in medical research, including an internal study commissioned by the government, that a country-wide PMTCT programme will prevent between 12,000 and 23,000 infections a year, and that such a programme would be both cost-effective and economical. Our concerns are therefore perfectly legitimate, and our demands reasonable. The state is bound by the Constitution to meet these obligations. Should you fail to make a satisfactory and adequate response, TAC will use every means at its disposal to achieve a country-wide PMTCT programme. Yours faithfully, Zackie Achmat (TAC Chairperson), Mark Heywood (TAC Secretary) ***************** Department of Health's Reply: PREVENTION OF MOTHER TO CHILD TRANSMISSION Thank you for your letter of the 26th April 2001, addressed to Minister Dr. Manto Tshabalala-Msimang on the above subject. Since some of the issues raised in your letter would necessitate consultation with parties outside the department, we will need more time to respond comprehensively to all your concerns. This we shall do at the soonest possible opportunity. With Thanks. MK MATSAUDEPUTY DIRECTOR GENERAL DATE: 30 APRIL 2001 ***************** 17 April 2001 The Chairperson Medicines Control Council For Attention: Dr Helen Rees Dear Dr Rees REGISTRATION OF NEVIRAPINE TO PREVENT MOTHER TO CHILD TRANSMISSION OF HIV The Treatment Action Campaign (TAC) is concerned about the continued delay in the registration of nevirapine to prevent mother to child transmission of HIV. TAC finds it unacceptable that this delay in registration is now also affecting the implementation of the government's mother to child transmission prevention research sites. TAC believes that you are vested with sufficient powers by legislation to ensure the speedy registration of nevirapine. TAC further believes that the delay thus far amounts to a serious miscarriage of justice and the continued failure to register nevirapine would regrettably leave us with no choice but to initiate legal action to defend the constitutional rights to life, dignity, health care, reproductive choice and the best interests of children. Kindly provide us, in writing, with reasons for the delay in registering nevirapine and outline the steps you have taken to ensure its speedy registration. We trust that you view this matter with the same sense of urgency and request that you respond within 48 hours of receipt of this letter. Yours sincerely Anneke Meerkotter for the Treatment Action Campaign